1
MARKAS BESAR ANGKATAN ANGKATAN DARAT DARAT DIREKTORAT DIRE KTORAT KESEHAT KESEH ATAN AN
KEPUTUSAN DIREKTUR KESEHATAN KESEHATAN ANGKATAN ANGKATAN DARAT Nomor : Kep/ 256 / VI / 2013 e!"!# PERATURAN INTERNA$ RUMAH SAKIT %HOSPITAL %HOSPITAL BYLAWS BYLAWS&& RSPAD GATOT SOEBROTO DITKESAD
DIREKTUR KESEHATAN ANGKATAN DARAT
Me!'m("!#
: 1) Ke(**+"! per"!' ,*!"- (er*p" (*-* pe.om"! *!*.'#*!"-"! e("#"' pe.om"! .","m me!#"*r I!er!", R*m"+ S"-' %Hop'", B,"& RSPAD G"o Soe(roo D'-e".
2) B"+ B"+" " *!* *!*- meme meme!* !*+' +' -e( -e(* **+ *+"! "! er ere e(* (* per per,* ,* .'.'-e, e,*" *"rr-"! "! Kep** Kep**" "! ! me!#e! me!#e!"' "' Per"* Per"*r"! r"! I!er! I!er!", ", R*m"+ R*m"+ S"-' S"-' %Hospital Bylaws& Bylaws& RSPAD G"o Soe(roo D'-e".)
Me!#'!#"
: 1) Per"*r"! Me!er' Kee+""! RI Nomor : 2/ MENKES/SK MENKES/SK/VI/20 /VI/2002 02 e!"!# e!"!# Pe.om"! Pe.om"! Per"*r"! Per"*r"! I!er!", I!er!", R*m"+ R*m"+ S"-' (Hospital By Laws). 2) Per" r"*r"! K"". Nomor Per-""./ 1 /VII/200 "!##", 5 4*,' 4*,' 200 200 me!# me!#e! e!"' "' pe!# pe!#e e"+ "+"! "! (er, (er,""-*! *!" " B*-* B*-* Pe* Pe*! !** A.m'!'r"' e!"!# T*,'"! T*,'"! D'!" .' ,'!#-*!#"! ,'!#-*!#"! TNI AD) 3) Per"* Per"*r"! r"! K"". K"". Nomor Nomor Per-" Per-""./ "./ 2 /VII/2 /VII/200 00 "!##" "!##",, 5 4*,' 4*,' 200 me!#e!"' pe!#e"+"! (er,"-*!" B*-* Pe*!*- A.m'!'r"' e! e!"! "!# # Pe! Pe!* **! *!"! "! ."! ."! Pe!e Pe!er( r('" '"! ! Do- Do-r'! r'!// B*-* B*-* Pe* Pe*! !** A!#-""! D"r") ) Kep**"! K"". Nomor Kep/ 50 /7II/2006 "!##", 28 Deem(er 2006 e!"!# Or#" RSPAD G"o Soe(roo D'-e".) 5) Kep**"! K"". Nomor Kep/ 50)" /7II/2006 "!##", 31 Deem(er 200 e!"!# Per*("+"!9I Or#" RSPAD G"o Soe(roo D'-e".)
Memp Memper er+" +"' '-" -"! ! : 1) S*r" S*r" Per'! Per'!" "+ + D'r-e D'r-e". ". Nomo Nomorr Spr'!/ Spr'!/ 6 6 /IV/2 /IV/201 013 3 "!## "!##", ", Apr', 2013 e!"!# Ke,ompo- Ker" Pe!**!"! B*-* Pe.om"! Hospital By Law s RSPAD G"o Soe(roo D'-e".)
2
2) H"', H"', per* per*m* m*"! "! Ke,o Ke,ompo mpo- Ker" Ker" Hospital By Law s RSPAD G"o Soe(roo D'-e".)
MEMUTUSKAN Me!e"p-"! :
1) Per"*r"! I! I !er!", R* R *m"+ S" S "-' %Hos % Hospit pital al By Laws Laws&& RSPAD RSPAD G"o G"o Soe(r Soe(roo oo D'-e D'-e". ". e("# e("#"'m "'m"!" "!" er"! er"!*m *m .","m .","m ,"mp'r ,"mp'r"! "! Kep**"! '!') 2)
B*-* B*-* Pe.om e.om"! "! '!' '!' (er-, er-," "'; ';''-" "' BIA BIASA) SA)
3)
Kep* Kep** *" "! ! '!' '!' (er, (er,""-* * e" e"- "!# "!##" #",, .'e .'e" "pp-"! "!))
D'e"p-"! .' 4"-"r" P"." "!##", 25 Nopem(er 2015 D're-*r Kee+""! A!#-""! D"r"
.r) B"m("!# S*,' Br'#".'r 4e!.er", TNI
D'r'(*' : 1) 2) 3) )
K" RSPAD G"o Soe(ro roo D'-e". Ke* Ke*" " Kom Kom' 'e e Me. Me.''- RSP RSPAD G"o G"o Soe Soe(r (ro oo o D' D'-e -e" ". . D'r( D'r('! '! "!me. !me. RSP RSPAD G"o "o Soe Soe(r (ro oo o D' D'-e" e". P"r" P"r" Ke* Ke*" " S"; S"; Me.' Me.'- <*!# <*!#' 'o! o!", ", RSP RSPAD G"o G"o Soe( Soe(ro roo o D'D'-e e". ".
Tem(*"! : 1) 2)
Ir.'-e". K"*(.'('!"( ="!-e D' D'-e".
3
$"mp'r"! Kep**"! D'r-e". Nomor Kep/ 256 / VI / 2013 T"!##", 25 4*!' 2013
MARKAS BESAR ANGKATAN ANGKATAN DARAT DIREKTORAT DIRE KTORAT KESEHAT KESE HATAN AN
PERATURAN INTERNAL RUMAH SAKIT (HOSPITAL BYLAWS) RSPAD GATOT SOEBROTO DITKESAD
BAB I PENDAHULUAN Umum Pasal 1 %1& %1&
R*m" R*m"+ + S"-' S"-' mer*p mer*p""-"! "! emp emp" " me! me!e, e,e! e!##" ##"r" r"-" -"! ! *p"" *p"" -ee -ee+" +"" "!) !) Up"" Up""
-ee+""! -ee+""! ".","+ ".","+ e'"p e'"p -e#'""! -e#'""! *!*- meme,'+"r" meme,'+"r" ."! me!'!#-"me!'!#-"-"! "! -ee+""! -ee+""! "!# (er**"! *!*- me**.-" me**.-"! ! .er"" .er"" -ee+"" -ee+""! ! "!# op'm", ("#' m""r"-" m""r"-") ) G*!" G*!" me," me,"- -"! "!""-"! "! *#" *#"! !" " r*m" r*m"+ + "-' "-' memp memp*! *!" "'' (er( (er("# "#"' "' ;*!# ;*!#' ' "' "'* * me!e,e!# me!e,e!##"r"#"r"-"! "! pe,""!" pe,""!"! ! me.'- me.'- pe,""!"! pe,""!"! pe!*!"!# pe!*!"!# me.'- ."! !o! me.'- me.'- pe," pe,"" "!" !"! ! ."! ."! "*+ "*+"! "! -epe -eper" r"" "" "! ! pe!# pe!#em em(" ("!# !#"! "! r** r**-" -"! ! pe!. pe!.'. '.''-"! "! ."! ."! pe,"'+"! pe!e,''"! ."! pe!#em("!#"! er" ".m'!'r"' *m*m -e*"!#"!) R*m"+ S"-' e("#"' '!'*' pe,""!"! -ee+""! "!# .' .","m!" "r" e-!o,o#' ."! ."!" er" e!"#" "!# m*,' .''p,'! "!#" m*!#-'! "-"! er".' -o!;,'- "!"r p'+"- "!# (er-e (er-epe! pe!'! '!#"! #"! ("'("'- "!"r" "!"r" *om *omer er .e!#"! .e!#"! pem(er pem(er'' pe," pe,""!" "!"! ! m"*p*! m"*p*! "!"r "!"r" " pe!#e,o," .e!#"! ";!") U!*- me!#"!''p"' -em*!#-'!"! -o!;,'- .' e(*"+ r*m"+ "-' .'per,*-"! "."!" *"* per"*r"! "!# me!#"*r +"- ."! -e"'("! em*" p'+"- "!# er,'(" m"*p*! "!# me!##*!"-"! ;"','" ."! "" e(*"+ r*m"+ "-')
%2 &
Per"*r"! I!er!", R*m"+ S"-' %Hospital Hospital Bylaws Bylaws& mer*p mer*p"-" "-"! ! ","+ ","+ "* "*
(e! (e!**- "*r "*r"! "! er er*, *,' ' "!# "!# (er, (er,""-* * .' *" *"* * r*m" r*m"+ + "-' "-' .e!# .e!#"! "! ** **"! "! *!* *!*me,'!.*!#' em*" p'+"- "!# er-"' e"r" ("'- ."! (e!"r (er.""r-"! r"" -e".',"!) D","m Per"*r"! I!er!", R*m"+ S"-' %Hospital % Hospital Bylaws& Bylaws& "-"! .'"*r per"! +"- ."! -e"'("! -e"'("! -e'#" -e'#" -ompo!e! -ompo!e! "!# (erper"! (erper"! (e"r (e"r .","m pe!#e,o,""! pe!#e,o,""! e(*"+ r*m"+ "-' "'* Pem','- erm"*- De"! Pe!#"" Kep"," R*m"+ S"-' ."! S"; Me.' <*!#'o!", "!# er#"(*!# .","m Kom'e Me.'-) Se,"'! '* Per"*r"! I!er!", R*m"+ S"-' S"-' %Hospital Hospital Bylaws Bylaws& "-"! "-"! me!" me!".' .' "*"! "*"! *"m" *"m" .","m .","m pe!#" pe!#"*r" *r"! ! +"- ."! -e"'("! p"'e! .' e(*"+ r*m"+ "-') Ke(er".""! Hospital By Laws em"-'! er""
4
pe!'!# .e!#"! "."!" per*("+"! p"r".'#m" r*m"+ "-' ."r' ,em("#" o'", me!".' ,em("#" o'",9e-o!om'- ."! ."p" .'".'-"! subyek hukum, e+'!##" +"r* me!".' per+"'"! em*" p'+"- er*"m" p"r" .o-er e!"#" -ee+""! ,"'!!" ."! pem','e(*"+ r*m"+ "-') %3&
RSPAD G"o Soe(roo D'-e". e("#"' R*m"+ S"-' TNI A!#-""! D"r"
.e!#"!
V'' > Me!".' R*m"+ S"-' Ber"!."r I!er!"'o!", Se("#"' R**-"!
Ter'!##' D"! R*m"+ S"-' Pe!.'.'-"! U"m" Ser" Ke("!##""! Pr"*r' D"! M""r"-" >? "!#" mem(**+-"! Per"*r"! I!er!", R*m"+ S"-' %Hospital Bylaws& "#"r er".' "" -e,o," r*m"+ "-' "!# ("'- memp*!"' m** pe,""!"! "!# pr'm" ."! "m"! ("#' p"'e!)
Tujua Pasal ! %1&
T**"! Um*m)
Se("#"' ""!"! per"*r"! .""r .' r*m"+ "-' "!#
me!#"*r Pem','- R*m"+ "-' ""* "!# me"-',' P'mp'!"! R*m"+ S"-' ."! Te!"#" Me.' e+'!##" pe!e,e!##"r""! R*m"+ S"-' ."p" e;e-'; e;''e! ."! (er-*",'") %2&
T**"! -+**) ") Se("#"' ""!"! "!# me!#"*r +*(*!#"! "!"r" Pem','- R*m"+ S"-' ""* "!# me"-',' P'mp'!"! R*m"+ S"-' ."! S"; Me.') () Se("#"' ""!"! "!# me!#"*r pem(*""! -e('"-"! e-!' oper"'o!", R*m"+ S"-') ) Se("#"' ""!"! "!# me!#"*r S"; Me.' <*!#'o!", %SM<& RSPAD G"o Soe(roo D'-e".)
Dasa" Pasal # %1&
U!."!#9U!."!# Nomor @ T"+*! 18 e!"!# Po-o-9Po-o- Kepe#""'"!
e("#"'m"!" e,"+ .'*("+ .e!#"! U!."!#9U!."!# Nomor 3 T"+*! 1888) %2&
U!."!#9U!."!# Rep*(,'- I!.o!e'" Nomor 28 T"+*! 200 e!"!# Pr"-'-
Ke.o-er"! %3&
U!."!#9U!."!# Rep*(,'- I!.o!e'" Nomor 36 T"+*! 2008 e!"!# Kee+""!
%&
U!."!#9U!."!# Rep*(,'- I!.o!e'" Nomor T"+*! 2008 e!"!# R*m"+
S"-')
5
%5&
Per"*r"! Me!er' Kee+""! Nomor 1586 / Me!-e / Per / II / 18@@ e!"!#
R*m"+ S"-') %6&
Per"*r"! Pemer'!"+ Nomor 32 T"+*! 1886 Te!"!# Te!"#" Kee+""!
%&
Per"*r"! Me!er' Kee+""! Nomor 30 / Me!-e / Per / III / 2010 e!"!#
K,"';'-"' R*m"+ S"-') %@&
Per"*r"! Me!er' Kee+""! Nomor 55 / Me!-e / Per / IV / 2011 e!"!#
Pe!e,e!##"r" Kom'e Me.'- ."! R*m"+ S"-') %8&
Kep**"! Me!er' Kee+""! RI Nomor 2 / Me!-e / SK / VI / 2002 e!"!#
Pe.om"! Per"*r"! I!er!", R*m"+ S"-' %HospitalByLaws&) %10&
Kep**"! Me!er' Kee+""! RI Nomor 631 / Me!-e / SK / IV / 2005 e!"!#
Pe.om"! Per"*r"! I!er!", S"; Me.' .' RS %Medical Staff By Laws&)
BAB II KETENTUAN UMUM
Nama, $%s%, M%s%, M&''&, (a Tu)as P&k&k Pasal * %1&
Nama+ R*m"+ "-' '!' ".","+ RSPAD G"o Soe(roo D'-e". m','- A!#-""! D"r"
.'(""+ Koor.'!"' D're-or" Kee+""! A!#-""! D"r" "!# er,e"- .' 4,!) A(.*, R"+m"! S",e+ No) 2 4"-"r" P*") Ber"* e("#"' r*m"+ "-' m','- D're-or" Kee+""! A!#-""! D"r")
%2&
$%s%+ Me!".' R*m"+ S"-' Ber"!."r I!er!"'o!", Se("#"' R**-"! Ter'!##' ."!
R*m"+ S"-' Pe!.'.'-"! U"m" Ser" Ke("!##""! Pr"*r' ."! M""r"-")
%3&
M%s%+ ")
Me!e,e!##"r"-"! ;*!#' R*m"+ S"-' '!#-" p*" ."! r**-"! er'!##'
("#' R*m"+ S"-' TNI A!#-""! D"r" .","m r"!#-" me!.*-*!# *#" po-oTNI A!#-""! D"r") ()
Me!e,e!##"r"-"! .*-*!#"! ."! pe,""!"! -ee+""! "!# (erm**
e"r" me!e,*r*+ *!*- pr"*r'/PNS TNI A!#-""! D"r" ."! -e,*"r#" er" m""r"-")
6
)
Me!#em("!#-"! -e',m*"! e"r" (er-e'!"m(*!#"!)
.)
Me!'!#-"-"!
-em"mp*"!
e!"#"
-ee+""!
me,",*'
pe!.'.'-"!
(er-e,"!*"!) e)
Mem(er'-"! ,'!#-*!#"! "!# me!.*-*!# proe pem(e,""r"! ."!
pe!e,''"! ("#' e!"#" -ee+""!)
%&
M&''& Kep*""! A!." H"r"p"! K"m'
%5&
Tu)as P&k&k) RSPAD G"o Soe(roo D'-e". me!e,e!##"r"-"! pe,""!"! per*m"+"-'"!
er'!##' .' ""r"! A!#-""! D"r" me,",*' *p""9*p"" pe,""!"! -ee+""! -*r"'; ."! re+"(','"'; "!# erp".* .e!#"! pe,"-"!""! -e#'""! -ee+""! promo'; ."! pree!'; .","m r"!#-" me!.*-*!# *#" po-o- D'-e".)
Pe)e"'%a-.e)e"'%a Pasal / D","m Per"*r"! I!er!", '!' "!# .'m"-*. .e!#"! : %1&
Pe"a'u"a I'e"al Rumah Sak%' 0Hospital By Laws ".","+ "*r"! .""r "!#
me!#"*r "" "r" pe!e,e!##"r""! r*m"+ "-' er" pem("#'"! *#"/-e"'("! ."! ee!"!# e"r" e," e#" ".', ."! propor'o!", "!"r" D're-*r Kee+""! A!#-""! D"r" Kep"," RSPAD G"o Soe(roo D'-e". ."! S"; Me.' <*!#'o!", %SM<& RSPAD G"o Soe(roo D'-e".)
%2&
Rumah Sak%' ".","+ R*m"+ S"-' P*" A!#-""! D"r" G"o Soe(roo
D'-e". "!# e,"!*!" .'e(* RSPAD G"o Soe(roo D'-e". .'m','-' o,e+ D're-or" Kee+""! A!#-""! D"r") %3&
P%m.%a RSPAD G"o Soe(roo D'-e". ".","+ "(""! r*-*r", "!#
er'!##' .' r*m"+ "-' "!# (er"!##*!# ""( "" pe!#e,o,""! r*m"+ "-' "!# .'p'mp'!!""'* : ")
Ke.ala RSPAD G"o Soe(roo D'-e". .''!#-" K" RSPAD G"o
Soe(roo D'-e".) ()
2ak%l Ke.ala RSPAD G"o Soe(roo D'-e". .''!#-" "-" RSPAD
G"o Soe(roo D'-e".)
7
%&
Pejaba' RSPAD G"o Soe(roo D'-e". ".","+ P'mp'!"! R*m"+ S"-' "!#
(er*#" .","m pe!#e,o,""! r*m"+ "-' "!# er.'r' ."r' %emp"& Ee,o! "'* Ee,o! P'mp'!"! Ee,o! Pem("!* P'mp'!"! Ee,o! Pe,""!"! ."! Ee,o! Pe,"-"!") %5&
Esel& Pemba'u P%m.%a ".","+ "."+ r*-*r", "!# er.'r' ."r' e!"#"
"+,' ""* pro;e' .'(e!*- *!*- mem(er'-"! per'm("!#"!9per'm("!#"! r"e#' pe!#"""! ."! pemer'-""! pem('!""! pe,""!"! me.'- pem('!""! pe,""!"! pe!*!"!# me.'- pem('!""! ."! pe!e,e!##"r""! -e#'""! pe!*!"!# *m*m ."! -e*"!#"! er" pem('!""! or#"!'"' -ep"." P'mp'!"! RSPAD G"o Soe(roo D'-e". .","m r"!#-" pe!'!#-""! ."! pe!#em("!#"! pe,""!"! r*m"+ "-' er" memp*!"' -ee!"!#"! ."! "!##*!# ""( ('."!# m"'!#9m"'!#) ="'* ?
%6&
")
Ke'ua K&m%'e Me(%k+
()
Ke'ua Ba(a Peaseha'+
)
Ke'ua K&m%'e R%se'+
.)
Ke.ala Sa'ua Pe)a3as I'e"al .''!#-" Ka SPI)
e)
D%"ek'u" Pemb%aa Pelayaa Me(%s .''!#-" D%"b%yame(+
;)
D%"ek'u" Pemb%aa Peuja) Me(%s .''!#-" D%"b%ja)me(+
#)
D%"ek'u" Pemb%aa Peuja) Umum .''!#-" D%"b%ja)um)
+)
D%"ek'u" Pemb%aa Pe)emba)a .''!#-" D%"b%ba)+
Esel& Pelayaa ".","+ "."+ r*-*r", "!# mer*p"-"! *!*r pe,""!"!
RSPAD G"o Soe(roo D'-e". "!# mem("!* P'mp'!"! .","m me!e,e!##"r"-"! -e#'""! .'('."!# pe!#"m"!"! pe,""!"! ".m'!'r"' pero!e, ,o#''- ."! *r*"! .","m -em"r-""! er" pem('!""! 'em pe!#o,"+"! ."" e-!'- '!;orm"'-" ."! pe!**!"! pro#r"m er" pe,"por"!) ="'* :
%&
")
Sek"e'a"%s .''!#-" Ses+
()
Ke.ala I4&"mas% (a Pe)&laha Da'a .''!#-" Ka%4&lah'a+
Esel& Pelaksaa ".","+ "."+ r*-*r", "!# mer*p"-"! *!*r pe,"-"!"
RSPAD G"o Soe(roo D'-e". "!# mem("!* P'mp'!"! .","m me!e,e!##"r"-"! -e#'""! .'('."!# pe,""!"! -ee+""! pe!.'.'-"! pe!e,''"! pe!#em("!#"! ',m* er" -e(**+"! ."! pe,""!"! *!*- me!*!"!# pe,""!"! -ee+""! ,"'!!" "!# .","m pe,"-"!""! *#"!" (er"!##*!# ""( -ep"." P'mp'!"! RSPAD G"o Soe(roo D'-e". ="'* :
8
")
Ke.ala De.a"'eme
%Be."+ Pe!"-' D","m 4'" O(er' C
G'!e-o,o#' I,m* Kee+""! A!"- 4"!*!# P"r* M"" S"r"; THT Pe!"-' K*,' C Ke,"m'! er" G'#' C M*,* ()
Ke.ala Is'alas%
0Re+"(','"' Me.'- R".'o,o#' C Ke.o-er"! N*-,'r
P"o,o#' G"" D"r*r" K"m"r Oper"' R"" 4","! R"" I!"p A!ee' C Re"!'m"' er" <"rm"' )
Ke.ala U%' 0Ke.o-er"! M','er Pemer'-""! Kee+""! G'' G*."!#
M"er'', Kee+""! $'!#-*!#"! C Noo-om'", Te-!'- Pe!.'.'-"! C Pe,"'+"! Te!"#" Kee+""! Pe!*!"!# K+**+
%@&
S'a4 Me(%s 5u)s%&al 0SM5 ".","+ -e,ompo- .o-er ."! .o-er #'#' .o-er
pe'",' ."! .o-er #'#' pe'",' %S"; Me.'& "!# (e-er" .' *!' pe,""!"! r*m"+ "-')
%8&
S'a4 Me(%s ".","+ eor"!# .o-er .o-er #'#' .o-er pe'",' .o-er #'#'
pe'",' .' RSPAD G"o Soe(roo D'-e". "!# e,"+ .'e**' ."! .'er'm" e*"' .e!#"! "*r"! "!# (er,"-* *!*- me!","!-"! pro;e' m"'!#9m"'!# .' RSPAD G"o Soe(roo D'-e".) %10&
D&k'e" (a D&k'e" )%)% ".","+ .o-er ."! ""* .o-er pe'",' er" .o-er #'#'
."! ""* .o-er #'#' pe'",' ,*,*"! pe!.'.'-"! -e.o-er"! ""* -e.o-er"! #'#' ("'.' .","m m"*p*! .' ,*"r !e#er' "!# .'"-*' o,e+ Pemer'!"+ Rep*(,'- I!.o!e'" e*"' .e!#"! per"*r"! per*!."!#9*!."!#"!)
%11&
D&k'e" 'e'a. ".","+ .o-er ."! ""* .o-er pe'",' er" .o-er #'#' ."! ""*
.o-er #'#' pe'",' "!# epe!*+!" (e-er" .' RSPAD G"o Soe(roo D'-e".)
%12&
D&k'e" '%(ak 'e'a. ".","+ .o-er ."! ""* .o-er pe'",' er" .o-er #'#' ."!
""* .o-er #'#' pe'",' "!# (e-er" .","m "!#-" "-* ere!* .' RSPAD G"o Soe(roo D'-e". ."! me!."p" ''! er*,' ."r' P'mp'!"!) %13&
D&k'e" K&sule ".","+ .o-er pe'",' ""* .o-er #'#' pe'",' ere!* ("'-
e"p ""* '."- e"p "!# -"re!" -ompee!'!" .'m'!" mem("!* pe,""!"! me.' .' RSPAD G"o Soe(roo D'-e". ."! me!."p" ''! er*,' ."r' P'mp'!"!)
9
%1&
D&k'e" Pea))u) 6a3ab Pelayaa 0DP6P ".","+ eor"!# .o-er
pe'",' "!# (er"!##*!#""( "" pe!#e,o,""! "*+"! me.' eor"!# p"'e!) %15&
Hak Kl%%s ".","+ -ee!"!#"! "!# .'(er'-"! o,e+ Kep"," RSPAD G"o
Soe(roo D'-e". -ep"." e!"#" me.' me,",*' *r" -ep**"! Kep"," RSPAD G"o Soe(roo D'-e". ee,"+ me!."p" per'm("!#"! ."r' Ke*" Kom'e Me.'-) %16&
Ra.a' ".","+ perem*"! "!# .',"-*-"! o,e+ P'mp'!"! Kom'e ."! U!'9*!'
-er" ,"'!!" e!"!# +",9+", "!# per,* .'r*m*-"! .'("+" er" .'p**-"!) %1&
K"e(es%al ".","+ *"* proe ;orm", p"." r*m"+ "-' ""* or#"!'"'
pe,""!"! -ee+""! "!# me!',"' ."! me!e"p-"! eor"!# .o-er "!# e,"+ mem','-' ,'e!' e+'!##" mempero,e+ +"- *!*- me,"-*-"! pe,""!"! p"." p"'e! .' r*m"+ "-') %1@&
Rek"e(es%al ".","+ proe ree",*"' er+"."p "; me.' "!# e,"+ mem','-'
-ee!"!#"! -,'!' (clinical priile!e) *!*- me!e!*-"! -e,""-"! pem(er'"! -ee!"!#"! -,'!' ere(*) %18&
Au(%' Me(%s ".","+ *p"" e",*"' e"r" pro;e'o!", er+"."p m**
pe,""!"! me.' "!# .'(er'-"! -ep"." p"'e! .e!#"! me!##*!"-"! re-"m me.'!" "!# .',"-"!"-"! o,e+ pro;e' me.') %20&
M%'"a Bes'a"% (peer group) ".","+ e-e,ompo- "; me.' .e!#"! rep*"' ."!
-ompee!' pro;e' "!# ("'- *!*- me!e,""+ e#"," +", "!# er-"' .e!#"! pro;e' me.') %21&
Pa%'%a 7 Sub K&m%'e ".","+ -e,ompo- -er" "!# .'(e!*- o,e+ Kom'e Me.'-
*!*- me!#""' m"","+ -+**) P"!''" .'e"p-"! .e!#"! *r" -ep**"! P'mp'!"! RSPAD G"o Soe(roo D'-e". "" **, Kom'e Me.'-) BAB III PENGORGANISASIAN
Ba)%a Kesa'u Pem%l%k Rumah Sak%' Pasal 8
10
D're-*r Kee+""! A!#-""! D"r" %D'r-e".& e"r" e" officio (er'!."- e("#"' pem','- me"-',' Te!"r" N"'o!", I!.o!e'" A!#-""! D"r")
Tu)as (a 2e3ea) D%"kesa( Pasal 9 %1&
D'r-e". me!e"p-"! V'' ."! M'' R*m"+ S"-' "!# .'"*-"! o,e+ P'mp'!"!
RSPAD G"o Soe(roo D'-e".)
%2&
D'r-e". me!#"*-"! **, Pe!e"p"! P'mp'!"! RSPAD G"o Soe(roo
D'-e". -ep"." K"". e*"' -ee!*"! pem('!""! pero!e, "!# (er,"-* .' $'!#-*!#"! A!#-""! D"r")
%3&
D'r-e". me,"-*-"! pe!',"'"! er+"."p -'!er" P'mp'!"! RSPAD G"o
Soe(roo D'-e". e*"' -ee!*"! pem('!""! pero!e, "!# (er,"-* .' $'!#-*!#"! A!#-""! D"r")
%&
D'r-e". me,"-*-"! pe!#"""! "" -e('"-"! P'mp'!"! RSPAD G"o
Soe(roo D'-e". .","m me!","!-"! r*m"+ "-' er" mem(er'-"! !"e+" -ep"." P'mp'!"! RSPAD G"o Soe(roo D'-e".)
%5&
D'r-e". e'"p "-* .","m "m -er" (er+"- mem"*-' r*m"+ "-' ."!
(er+"- memer'-" em*" pem(*-*"! *r" ."! "," (*-' ,"'!!" memer'-" ."! me!oo--"! -e".""! *"!# -" ."! ,"'! ,"'! er" (er+"- *!*- me!#e"+*' e#"," '!."-"! "!# e,"+ .'","!-"! o,e+ P'mp'!"! RSPAD G"o Soe(roo D'-e".)
%6&
D'r-e". (er+"- me!#'-*' r"p" "!# .',"-"!"-"! o,e+ P'mp'!"! ."! Pe"("
RSPAD G"o Soe(roo D'-e". ."! (er+"- me!#"."-"! r"p" *!*- mem'!" pe!e,""! ."r' P'mp'!"! ."! Pe"(" RSPAD G"o Soe(roo D'-e". e!"!# pe!#e,o,""! R*m"+ S"-')
%&
D'r-e". (er+"- me!."p"-"! pe!e,""! ."r' P'mp'!"! RSPAD G"o Soe(roo
D'-e". ."! e,*r*+ Pe"(" RSPAD G"o Soe(roo D'-e". e!"!# e#"," +", me!#e!"' pe!#e,o,""! r*m"+ "-' ("'- .' .","m r"p" m"*p*! .' ,*"r r"p") P'mp'!"!
11
."! Pe"(" RSPAD G"o Soe(roo "'( *!*- mem(er'-"! pe!e,""! e!"!# e#"," +", "!# .'"!"-"! o,e+ D'r-e".)
Ba)%a Ke(ua De3a Pe)a3as Rumah Sak%'
Pasal : %1&
De"! Pe!#"" RSPAD G"o Soe(roo D'-e". ".","+ De"! "!# .'*!*-
""* .'(e!*- me,",*' *r" -ep**"! D'r-e". "" !"m" K"". er.'r' ."r' :
%2&
")
Ir.'-e". e("#"' Ke*")
()
K"*(.'('!"!-e D'-e". e("#"' A!##o")
)
Ke*" ="""! "+"!" B+"-' K"r" H*"." e("#"' A!##o")
D","m +", er".' -e-oo!#"! e,*r*+ ""* e("#'"! De"! Pe!#"" m"-"
.","m "!#-" "-* p",'!# ,"m" 30 +"r' e"- er".'!" -e-oo!#"! ere(* D'r-e". +"r* me!e,e!##"r"-"! r"p" *!*- me!#"!#-" De"! Pe!#"" ("r*)
Tu)as (a Ke3aj%ba Pasal ; %1&
Me,"-*-"! pe!#"""! er+"."p pe!#e,o,""! RSPAD G"o Soe(roo D'-e".
"!# .',"-*-"! o,e+ K" RSPAD G"o Soe(roo D'-e". me!#e!"' pe,"-"!""! Re!"!" Ker" ."! A!##"r"! Re!"!" Sr"e#' B'!' 4"!#-" P"!"!# ."! -ee!*"! per"*r"! per*!."!#9*!."!#"! "!# (er,"-*) %2&
De"! Pe!#"" .","m me,"-*-"! *#"!" (er-e"'("! : ")
Mem(er'-"! pe!."p" ."! "r"! me!#e!"' re!"!" -er" ."! "!##"r"!
RSPAD G"o Soe(roo D'-e".) ()
Me!#'-*' per-em("!#"! -e#'""! .' RSPAD G"o Soe(roo D'-e".
."! mem(er'-"! pe!."p" ."! "r"! me!#e!"' e'"p m"","+ "!# .'"!##"p pe!'!# ("#' pe!#*r* RSPAD G"o Soe(roo D'-e".) )
Mem(er'-"! !"e+" -ep"." K" RSPAD G"o Soe(roo D'-e".
.","m me,"-"!"-"! pe!#*r*"! r*m"+ "-')
12
.)
Me!er'm" pe!#".*"! ."r' p"r" p'+"- *omer ("'- '!er!", m"*p*!
e-er!",)
%3&
De"! Pe!#"" me,"por-"! pe,"-"!""! *#"!" -ep"." D'r-e". e"r"
(er-"," p",'!# e.'-'
"* -",' .","m "* emeer ."! ""* e"-*9"-* '-"
.'per,*-"!) 2e3ea) Pasal 1<
D","m me,"-"!"-"! *#" ."! -e"'("!!" De"! Pe!#"" memp*!"' ee!"!# e("#"' (er'-* : %1&
Me,'+" (*-*9(*-* *r"9*r" er" .o-*me!9.o-*me! ,"'!!" "!#
(er-"'"! .e!#"! pe,"por"! "!# .'er'm"!" *!*- -,"r';'-"')
%2&
Mem'!" pe!e,""! ."r' P'mp'!"! ."! Pe"(" RSPAD G"o Soe(roo
D'-e". er" pero!e, "!# er-"' e!"!# e#"," pero","! "!# me!"!#-* pe!#*r*"! r*m"+ "-') %3&
Mem'!" P'mp'!"! ."! Pe"(" RSPAD G"o Soe(roo D'-e". er"
pero!e, "!# er-"' *!*- me!#+".'r' r"p" "!# (er-"'"! .e!#"! Per*m"+"-'"!) %&
Mem(er'-"! re-ome!."' ."! ("!*"! -ep"." P'mp'!"!
RSPAD G"o
Soe(roo D'-e". .","m me,"-*-"! per(*""! +*-*m ere!*)
Ba)%a Ke'%)a P%m.%a (a Pejaba' RSPAD Ga'&' S&eb"&'& D%'kesa(
Pasal 11
13
%1&
P%m.%a RSPAD G"o Soe(roo D'-e". ".","+ "(""! Sr*-*r", "!#
er'!##' .' r*m"+ "-' "!# (er"!##*!# ""( "" pe!#e,o,""! r*m"+ "-' "!# .'p'mp'!!" "'* : ")
Ke.ala RSPAD G"o Soe(roo D'-e". .''!#-" K" RSPAD G"o
Soe(roo D'-e".) ()
2ak%l Ke.ala RSPAD G"o Soe(roo D'-e". .''!#-" "-" RSPAD
G"o Soe(roo D'-e".)
%2&
Kep"," RSPAD G"o Soe(roo D'-e". memp*!"' *#" po-o- : ")
Se("#"' P'mp'!"! RSPAD G"o Soe(roo D'-e". ."p" meme,'+"r"
"" er'(
.''p,'!
ere,e!##"r"!"
."! e#"-!"
pe,"-"!""!
+*-*m
*#"
er"
pe!#e!.",' pe!#"" me!#*p""-"!
*!*-
-ee"+er""!
pero!e,/pe#""' RSPAD G"o Soe(roo D'-e".) ()
Se("#"' pem('!" ;*!#' per*m"+"-'"! K" RSPAD G"o Soe(roo
D'-e". memp*!"' -e"'("! : 1&
Me!"m'! ere,e!##"r"!" *#"9*#" RSPAD G"o Soe(roo
D'-e". e"r" (er+"', ."! (er."" #*!") 2&
Me!**!
pro#r"m -er" RSPAD G"o Soe(roo D'-e".
(er.""r-"! Re!r" ."! pro#r"m -er" D'-e".) 3&
Mem('!" ."! me!e,e!##"r"-"! or#"!'"' 'em meo." er"
proe.*r -er" .' ,'!#-*!#"! RSPAD G"o Soe(roo D'-e". &
Me!e"p-"!
-e('"-"!
pe!e,e!##"r""!
;*!#'
pe,""!"!
-ee+""! .' R*m"+ S"-' (er.""r-"! 'em "!# (er,"-* e*"' per-em("!#"! ',m* ."! e-!o,o#' .' ('."!# -ee+""!) 5&
Me!e,e!##"r"-"! ."! me,"-"!"-"! pe,""!"! -ee+""! ("#'
pero!e, TNI A!#-""! D"r" (eer" -e,*"r#"!") 6&
Me!"m'! er"p"'!" "r"!" Pro#r"m Ker" RSPAD G"o
Soe(roo D'-e". e"r" e;e-'; ."! e;''e!) &
Mem('!"
m"er'',
RSPAD
G"o
Soe(roo
D'-e".
e*"'
-ee!*"! ."! per*!."!#9*!."!#"! "!# (er,"-*) @&
Mem("!* D'r-e". .","m pe,"-"!""! *per'' e-!' me.'
er+"."p R*m"+ S"-' A!#-""! D"r" .' '!#-" Ko."m)
%3&
Kep"," RSPAD G"o Soe(roo D'-e". (ere!"!# *!*- :
14
")
Mem'mp'! ."! me!#e,o," R*m"+ S"-' e*"' .e!#"! **"! R*m"+
S"-' .e!#"! e!"!'"" (er*"+" me!'!#-"-"! ."" #*!" ."! +"', #*!") ()
Me!#*""' meme,'+"r" ."! me!#e,o," -e-"""! R*m"+ S"-')
)
Me"-',' R*m"+ S"-' .'.","m ."! .',*"r pe!#".',"!)
.)
Me,"-"!"-"! -e('"-"! pe!#em("!#"! *"+" .","m me!#e,o," R*m"+
S"-' e("#"'m"!" "!# e,"+ .'#"r'-"! o,e+ TNI AD/D'-e".) e)
Me!e"p-"! -e('"-"! oper"'o!", R*m"+ S"-')
;)
Me!'"p-"! Re!"!" 4"!#-" P"!"!# ."! Re!"!" Ker" ."! A!##"r"!
R*m"+ S"-') #)
Me!#"."-"! ."! meme,'+"r" pem(*-*"! er" ".m'!'r"' R*m"+ S"-'
e*"' .e!#"! -e,"'m"! "!# (er,"-* ("#' e(*"+ r*m"+ "-') +)
Me!er"p-"! Sr*-*r Or#"!'"' ."! "" -er" R*m"+ S"-' ,e!#-"p
.e!#"! r'!'"! *#"!" ee,"+ .'e**' o,e+ TNI AD/D'-e".) ')
Me!#"!#-" ."! mem(er+e!'-"! e!"#" +o!orer e*"' per"*r"!
per*!."!# *!."!#"! "!# (er,"-*) )
Me!'"p-"! ,"por"! "+*!"! ."! ,"por"! (er-",")
-)
Me!#"*-"! **,"! '' ."! m'' R*m"+ S"-' ."! me,"-"!"-"! re'e
(er-"," e'"p "+*!)
%&
D","m pe,"-"!""! *#" ."! -e"'("!!" K" RSPAD G"o Soe(roo
D'-e". .'("!* o,e+ "-" RSPAD G"o Soe(roo D'-e". er" pe"("9pe"(" p"." Ee,o! Pem("!* P'mp'!"! Ee,o! Pe,""!"! ."! Ee,o! Pe,"-"!" "!# memp*!"' *#" ."! "!##*!# ""( e*"' ('."!# m"'!#9m"'!# e*"' Or#"!'"' ."! T*#" RSPAD G"o Soe(roo D'-e".)
Pasal 1! %1&
Kep"," RSPAD G"o Soe(roo D'-e". (er+"- ."! (ere!"!# (er'!."- *!*-
."! "" !"m" r*m"+ "-')
%2&
D","m +", Kep"," RSPAD G"o Soe(roo D'-e". '."- +".'r ""* (er+","!#"!
-"re!" e("( "p"p*! *#" +", m"!" '."- per,* .'(*-'-"! -ep"." p'+"- -e'#" m"-" "-', Kep"," RSPAD G"o Soe(roo D'-e". (er+"- ."! (ere!"!# (er'!."- *!*."! "" !"m" r*m"+ "-')
15
Pejaba' RSPAD Ga'&' S&eb"&'& D%'kesa( Pasal 1# %1&
Pe,"-"!""! -e#'""! e"r" -ee,*r*+"! .' RSPAD G"o Soe(roo D'-e".
.',"-*-"! o,e+ Pe"(" RSPAD G"o Soe(roo D'-e".) %2&
Pe"(" RSPAD G"o Soe(roo D'-e". .'**! .","m %emp"& Ee,o! "'*
Ee,o! P'mp'!"! Ee,o! Pem("!* P'mp'!"! Ee,o! Pe,""!"! ."! Ee,o! Pe,"-"!") %3&
Pe"(" RSPAD G"o Soe(roo D'-e". .'"!#-" ."! .'(er+e!'-"! ."r'
"(""!!" (er.""r-"! Kep**"! Kep"," S"; A!#-""! D"r" %K"".& "" **, D're-*r Kee+""! A!#-""! D"r" %D'r-e".&)
2e3ea) (a Ta))u) 6a3ab Pejaba' RSPAD Pasal 1* Pe"(" RSPAD G"o Soe(roo D'-e". memp*!"' ee!"!# ."! "!##*!# ""( e("#"' (er'-* : %1&
Me!**! -e('"-"!""! pe,"-"!""! -e#'""! .' r*m"+ "-'
%2&
Mem('!" pe,"-"!""! -e#'""! .' r*m"+ "-')
%3&
Me!#-oor.'!"'-"! ."! me!#""' pe,"-"!""! *#" r*m"+ "-' e*"'
.e!#"! per"*r"! ."! per*!."!#9*!."!#"! "!# (er,"-*) %&
Me!**! re!"!" -er" ."! re!"!" "!##"r"! "+*!"!)
%5&
Me,"-"!"-"! pro#r"m -er" ."! "!##"r"! "+*!"! "!# e,"+ .'e**'
%6&
Me!#**,-"! re!"!" pem("!#*!"! ."! pe!#em("!#"! "r"!" ."! pr""r"!"
r*m"+ "-' "!# .'per,*-"! e","! .e!#"! -e(**+"! "" pe!#em("!#"! .'m"" .ep"! %&
Me!e"p-"! -e('"-"! *m*m -e*"!#"! ."! pe,""!"! r*m"+ "-' e("#"'
pe.om"! pe,"-"!""! *#" p"r" pe#""' .e!#"! "r" me!#"!",'' r"!"!#"! **,"! "!# e,"+ .'r*m*-"! o,e+ P'mp'!"! RSPAD G"o Soe(roo D'-e".) %@&
Me!e"p-"! S"!."r Proe.*r Oper"'o!", %SPO& pe,""!"! -ee+""!)
%8&
Me!e"p-"! **,"! ."! pe!e"p"! "r'; pe,""!"! r*m"+ "-')
%10&
Me!e"p-"! ,"por"! "-*!"(','" -'!er" r*m"+ "-' e*"' .e!#"! per"*r"!
per*!."!#9*!."!#"! "!# (er,"-*) %11&
Me!e"p-"!
,"por"!
-e*"!#"!
per*!."!#9*!."!#"! "!# (er,"-*)
r*m"+
"-'
e*"'
.e!#"!
per"*r"!
16
%12&
Me!e"p-"! ,"por"! pe,"-"!""! e,*r*+ -e#'""! r*m"+ "-' e"r" (er-","
."! '!'.e!', .e!#"! "r" me!#"!",'' r"!"!#"! ,"por"! "!# .'**! Pe"(" RSPAD G"o Soe(roo D'-e".) %13&
Pe!e"p-"! .";"r !',"' -'!er" pe#""' RSPAD G"o Soe(roo D'-e".)
%1&
Me,"-"!"-"! *#" ,"'! .","m r"!#-" -e,"!"r"! pe,"-"!""! *#" ."!
pe!#em("!#"! RSPAD G"o Soe(roo D'-e".)
Pasal 1/ %1& Pe"(" RSPAD G"o Soe(roo D'-e". (er"!##*!# ""( pe!*+ .","m me,"-"!"-"! *#"!" *!*- -epe!'!#"! R*m"+ S"-' .","m me!"p"' m"-*. ."! **"!!")
%2& Se'"p Pe"(" RSPAD G"o Soe(roo D'-e". "'( .e!#"! ''-". ("'- ."! pe!*+ "!##*!# ""( me!","!-"! *#"!" .e!#"! me!#'!."+-"! per"*r"! per*!."!#9*!."!#"! "!# (er,"-* e+'!##" pe,""!"! "!# .'(er'-"! -ep"." p"'e! ".","+ "!# er("'-)
%3& Se'"p Pe"(" RSPAD G"o Soe(roo D'-e". +"r* ."p" (e-er""m" .e!#"! "; me.'- .e!#"! memper+"'-"! per"! ."! ;*!#' m"'!#9m"'!# e+'!##" **"! R*m"+ S"-' ."p" er"p"')
Ba)%a Keem.a' K&m%'e Me(%k Pasal 18 %1&
Kom'e Me.'- .'(e!*- .e!#"! **"! *!*- me!e,e!##"r"-"! "" -e,o," -,'!'
%clinical !oernance& "!# ("'- "#"r m** pe,""!"! me.' ."! -ee,"m""! p"'e! ,e('+ er"m'! ."! er,'!.*!#') %2&
Kom'e Me.'- mer*p"-"! or#"!'"' !o! r*-*r", "!# .'(e!*- .' r*m"+ "-'
o,e+ Kep"," RSPAD G"o Soe(roo D'-e". )
%3&
Kom'e Me.'- e("#"'m"!" .'m"-*. p"." "" %2& (*-"! mer*p"-"! "."+
per"-',"! ."r' "; me.')
17
%&
Ke"!##o""! Kom'e Me.'- .'e"p-"! o,e+ Kep"," RSPAD G"o Soe(roo
D'-e". .e!#"! memper'm("!#-"! '-"p pro;e'o!", rep*"' ."! per',"-*) %5&
4*m,"+ -e"!##o""! Kom'e Me.'- e("#"'m"!" .'m"-*. p"." "" %&
.'e*"'-"! .e!#"! *m,"+ "; me.' .' r*m"+ "-') Nama (a s'"uk'u" O")a%sas% Pasal 19 %1&
N"m" or#"!'"' Kom'e Me.'- ".","+ "."+ pro;e'o!", me.' "!#
"!##o"!" er.'r' ."r' Ke*"9-e*" S"; Me.' <*!#'o!", ."! ""* "!# me"-',' .''p,'! ',m* ere!*)
%2&
Kom'e Me.'- .'p'mp'! o,e+ eor"!# -e*" ."! memp*!"' oor'" er'!##'
.","m pe!#or#"!'"'"! "; me.') %3&
Ke*" Kom'e Me.'- .'e"p-"! (er.""r-"! Kep**"! K"". "" **,
D'r-e".) %&
Se-re"r' Kom'e Me.'- ."! Ke*" S*(-om'e .'e"p-"! o,e+ Kep"," RSPAD
G"o Soe(roo D'-e". (er.""r-"! re-ome!."' ."r' Ke*" Kom'e Me.'- .e!#"! memper+"'-"! m"*-"! ."r' "; me.' "!# (e-er" .' r*m"+ "-')
%5&
%6&
S**!"! -epe!#*r*"! Kom'e Me.'- er.'r' ."r' : ")
Ke*")
()
Ke*" S*( Kom'e ."! "!##o"
)
Se-re"r'
.)
A!##o"
M"" ("-' -epe!#*r*"! Kom'e Me.'- (er.""r-"! -ee"p"! Kep"," RSPAD G"o Soe(roo D'-e". )
Pasal 1:
18
%1&
Kom'e Me.'- (er;*!#' e("#"' pe!#"r"+ .","m pem(er'"! pe,""!"! me.'
e."!#-"! S"; Me.' <*!#'o!", %SM<& e("#"' pe,"-"!" pe,""!"! me.' .' e,*r*+ *!' pe,""!"! RSPAD G"o Soe(roo D'-e".)
%2&
Kom'e Me.'- memp*!"' *#" me!'!#-"-"! pro;e'o!",'me "; me.' "!#
(e-er" .' r*m"+ "-' .e!#"! "r" : ")
Me,"-*-"! -re.e!'", ("#' e,*r*+ "; me.' "!# "-"! me,"-*-"!
pe,""!"! me.' .' r*m"+ "-') ()
Meme,'+"r" m** pro;e' "; me.')
)
Me!"#" .''p,'! e'-" ."! per',"-* pro;e' "; me.')
Pasal 1; %1&
D","m me,"-"!"-"! *#" -re.e!'", Kom'e Me.'- mem','-' ;*!#' e("#"' (er'-* : ")
Me!**! ."! me!#-omp',"' .";"r -ee!"!#"! -,'!' e*"' .e!#"!
m"*-"! ."r' -e,ompo- "; me.' (er.""r-"! !orm" -epro;e'"! "!# (er,"-*) ()
)
Me!e,e!##"r"-"! pemer'-""! ."! pe!#-"'"! e!"!# : 1&
Kompee!')
2&
Kee+""! ;''- ."! me!",)
3&
Per',"-*)
&
E'-" pro;e')
Me,"-*-"! e",*"' ."" pe!.'.'-"! pro;e'o!", -e.o-er"!/-e.o-er"! #'#'
(er-e,"!*"!) .)
Me,"-*-"! ""!"r" er+"."p pemo+o! -ee!"!#"! -,'!')
e)
Me,"-*-"! pe!',"'"! ."! pem**"! -ee!"!#"! -,'!' "!# ".e-*")
;)
Mem(*"
,"por"!
+"',
pe!',"'"!
-re.e!'",
."!
me!"mp"'-"!
re-ome!."' -ee!"!#"! -,'!' -ep"." Kom'e Me.'-) #)
Me,"-*-"! proe re-re.e!'", p"." "" (er"-+'r!" m"" (er,"-* *r"
pe!*#""! -,'!' ."! "."!" perm'!""! ."r' Kom'e Me.'-)
%2&
D","m me,"-"!"-"! *#" meme,'+"r" m** pro;e' "; me.' Kom'e Me.'-
mem','-' ;*!#' e("#"' (er'-* : ")
Pe,"-"!""! "*.' me.'
19
()
Mem(er'-"!
re-ome!."'
perem*"!
',m'"+
.","m
r"!#-"
pe!.'.'-"! (er-e,"!*"! ("#' "; me.') )
Mem(er'-"! re-ome!."' proe pe!."mp'!#"! (proctorin!) ("#'
"; me.' "!# mem(**+-"!)
%3&
D","m me,"-"!"-"! *#" me!"#" .''p,'! e'-" ."! per',"-* pro;e' ";
me.' Kom'e Me.'- mem','-' ;*!#' e("#"' (er'-* : ")
Pem('!""! e'-" ."! .''p,'! pro;e' -e.o-er"!)
()
Pemer'-""! "; me.' "!# .'.*#" me,"-*-"! pe,"!##"r"! .''p,'!)
)
Re-ome!."' pe!.''p,'!"! pe,"-* pro;e'o!", .' r*m"+ "-')
.)
Pem(er'"! !"e+"/per'm("!#"! .","m pe!#"m(',"! -ep**"! e'
p"." "*+"! me.' p"'e!)
Tu)as K&m%'e Me(%k Pasal !< U!*- me,"-"!"-"! ;*!#'!" Kom'e Me.'- memp*!"' T*#" e("#"' (er'-* : %1&
Mem("!* P'mp'!"! RSPAD G"o Soe(roo D'-e". me!**! "!."r
pe,""!"! me.' ."! mem"!"* pe,"-"!""!!")
%2&
Mem("!* P'mp'!"! RSPAD G"o Soe(roo D'-e". me!**! #edical staff
$ylaws ."! mem"!"* pe,"-"!""!!") %3&
Mem("!* P'mp'!"! RSPAD G"o Soe(roo D'-e". me!**! -e('"-"! ."!
proe.*r "!# er-"' me.'o9,e#", ."! e'-o9,e#",) %&
Me,"-*-"! -oor.'!"' .e!#"! P'mp'!"! RSPAD G"o Soe(roo D'-e". .","m
me,"-"!"-"! pem"!"*"! ."! pem('!""! pe,"-"!""! *#" SM<) %5&
Me!#"*r -ee!"!#"! pro;e' ."! SM<)
%6&
Me,"-"!"-"! pem('!""! e'-" pro;e' .''p,'! pro;e' ."! m** pro;e')
%&
Me,"-*-"! pem"!"*"! ."! e",*"' m** pe,""!"! me.')
%@&
Me!'!#-"-"! pro#r"m pe,""!"! pe!.'.'-"! ."! pe,"'+"! er" pe!e,''"! ."!
pe!#em("!#"! .","m ('."!# me.')
20
2e3ea) K&m%'e Me(%k Pasal !1 %1&
Mem(er'-"! **, re!"!" -e(**+"! ."! pe!'!#-""! -*",'" e!"#" me.')
%2&
Mem(er'-"! per'm("!#"! e!"!# re!"!" pe!#".""! pe!##*!""! ."!
peme,'+"r""! per",""! pe,""!"! me.' ."! per",""! pe!*!"!# me.' er" pe!#em("!#"! pe,""!"! me.') %3&
Mem(e!*- T'm K,'!' "!# memp*!"' *#" me!"!#"!' -"*9-"*
pe,""!"! me.' "!# memer,*-"! -oor.'!"' ,'!" pro;e') %&
Mem"!"* ."! me!#e",*"' pe!##*!""! o(" .' R*m"+ "-')
%5&
Mem"!"* ."! me!#e",*"' e;''e!' ."! e;e-''" pe!##*!""! ","
-e.o-er"! .' R*m"+ S"-') %6&
Me,"-"!"-"! pem('!""! E'-" Pro;e' er" me!#"*r -ee!"!#"! pro;e'
"!##o" S"; Me.'- <*!#'o!",) %&
Mem(er'-"! re-ome!."' e!"!# -er""m" "!"r" R*m"+ S"-' ."! <"-*,"
Ke.o-er"! / Ke.o-er"! G'#' / I!","' pe!.'.'-"! ,"'!) %@&
Me!e"p-"! *#" ."! -e"'("! S*( Kom'e/P"!''" .","m ,'!#-*!#"! Kom'e
Me.'-)
Pa%'%a A(-h&= Pasal !! %1&
D","m me,"-"!"-"! *#" ."! ;*!#'!" Kom'e Me.'- ."p" .'("!* o,e+
P"!''" Ad%&oc ) %2&
P"!''" Ad%&oc e("#"'m"!" .'m"-*. p"." "" %1& .'e"p-"! o,e+ K" RSPAD
G"o Soe(roo D'-e". (er.""r-"! **,"! Ke*" Kom'e Me.'-) %3&
P"!''" Ad%&oc e("#"'m"!" .'m"-*. p"." "" %1& (er"", ."r' "; me.'
"!# er#o,o!# e("#"' m'r" (e"r') %&
S"; me.' "!# er#o,o!# e("#"' m'r" (e"r' e("#"'m"!" .'m"-*. p"."
"" %3& ."p" (er"", ."r' r*m"+ "-' ,"'! per+'mp*!"! .o-er pe'",'/.o-er #'#'
21
pe'",' -o,e#'*m .o-er/.o-er #'#' -o,e#'*m .o-er pe'",'/.o-er #'#' pe'",' ."!/""* '!'*' pe!.'.'-"! -e.o-er"!/-e.o-er"! #'#')
BAB I$ PELAKSANAAN TATA KELOLA RUMAH SAKIT
Ra.a' Pasal !# %1&
D","m me!","!-"! *#" ."! -e"'("!!" me!#e,o," r*m"+ "-' P'mp'!"!
RSPAD G"o Soe(roo D'-e". me!#"."-"! r"p" e("#"' (er'-* :
%2&
")
R"p" P'mp'!"!
()
R"p" S";
)
R"p" K+**
R"p" P'mp'!"! .'+".'r' o,e+ K"r*m-'/"-" Ke*" Kom'e Me.'- Kep","
S"*"! Pe!#"" I!er!", Kep"," B"."! Pe!"e+" P"r" D'r('!/Se/K" I!;o,"+" ."! Pe"(" ,"'! "!# .'e!*-"! o,e+ P'mp'!"! RSPAD G"o Soe(roo D'-e".)
%3&
R"p" P'mp'!"! RSPAD G"o Soe(roo D'-e". .'e,e!##"r"-"! e-*r"!#
-*r"!#!" 1 %"*& m'!##* e-",') %&
R"p" P'mp'!"! .'p'mp'! o,e+ K") RSPAD G"o Soe(roo D'-e". ""* Per'r"
er*" "!# +".'r .","m r"p")
%5&
R"p" S"; .'+".'r' o,e+ K"r*m-'/"-" Ke*" Kom'e Me.'- K" SPI Ke*" BP
P"r" D'r('! Se K" I!;o,"+" P"r" K".ep/K" I!", ."! Pe"(" ,"'! "!# .'e!*-"! o,e+ P'mp'!"! RSPAD G"o Soe(roo D'-e".)
%6&
R"p" "; RSPAD G"o Soe(roo .'e,e!##"r"-"! e-*r"!#9-*r"!#!" 1
%"*& (*,"! e-",') %&
R"p" S"; .'p'mp'! o,e+ P'mp'!"! RSPAD G"o Soe(roo D'-e". ""*
Per'r" er*" "!# +".'r .","m r"p")
%@&
R"p" -+** .',"-"!"-"! e*"' -e(**+"! ."! "" pe*!*- P'mp'!"!)
22
%8&
R"p" -+** .'+".'r' o,e+ Pem','-/De"! Pe!#"" P'mp'!"! RSPAD G"o
Soe(roo D'-e". ."! Pe"(" ,"'! "!# .'*!*- *!*- me!e"p-"! -e('"-"! +",9+", -+** "!# '."- erm"*- .","m r"p" p'mp'!"! m"*p*! r"p" ";)
%10&
U!*- e'"p r"p" .'(*" !o*,e! r"p" o,e+ Se-re"r' ""* Pe"(" ,"'! "!#
.'e"p-"! .","m e'"p r"p" "!# .'"."-"!)
%11&
Kep**"! "!# .'e"p-"! .","m r"p" "-"! (er,"-* e;e-'; ."! me!#'-"
ee,"+ .'er('-"! *r" -ep**"! ."! ""* *r" per'!"+ ."r' D'r-e". ."! ""* K") RSPAD G"o Soe(roo D'-e". e*"' -ee!*"! "!# (er,"-* .' ,'!#-*!#"! TNI AD)
S'em.el Rumah Sak%' Pasal !* %1& P'mp'!"! RSPAD G"o Soe(roo D'-e". (er"!##*!# ""( "" -e"m"!"! pe!##*!""! Sempe, r*m"+ "-' *!*- -epe!'!#"! oper"'o!", r*m"+ "-')
%2& Se'"p -e('"-"! p'mp'!"! RSPAD G"o Soe(roo D'-e". me!#e!"' pe!#e,o,""! r*m"+ "-' .'*"!#-"! .","m (e!*- *r" -ep**"! ""* *r" per'!"+ ""* .","m (e!*- ,"'! e*"' m'!* TNI AD +"r* .'(*(*+' empe, r*m"+ "-') %3& Pe!##*!""! Sempe, r*m"+ "-' .'e!*-"! ,e('+ ,"!* o,e+ Se RSPAD G"o Soe(roo D'-e".)
Pee'a.a Re=aa S'"a'e)%s, P"&)"am Ke"ja (a A))a"a RS Pasal !/ %1&
Re!"!" Sr"e#' %Re!r"& R*m"+ S"-' .'(*" *!*- "!#-" "-* 5 %,'m"&
"+*!)
%2&
Pro#r"m Ker" ."! "!##"r"! %Pro#"& R*m"+ S"-' .'(*" *!*- "!#-" "-* 1
%"*& "+*! me!#"* p"." Re!r" R*m"+ S"-') %3&
Re!r" ."! Pro#" R*m"+ S"-' .'"*-"! o,e+ P'mp'!"! RSPAD G"o
Soe(roo D'-e". -ep"." D'r-e". *!*- me!."p"-"! pe!#e"+"! ."! pe!e"p"!)
23
Pasal !8 %1&
Se'"p U!' -er" me!#**,-"! Re!r" ."! pro#" *!'!" -ep"." P'mp'!"!
RSPAD G"o Soe(roo D'-e".)
%2&
U*,"! Re!r" ."! pro#" "!# .'"*-"! .'("+" .","m r"p" *!*-
me!."p"-"! pere**"!) %3&
U*,"! Re!r" ."! pro#" "!# e,"+ .'e**' .","m r"p" .'"*-"! -ep"."
D'r-e". *!*- me!."p"-"! pe!#e"+"!)
Pasal !9 %1&
B'," .","m pe,"-"!""! Pro#r"m Ker" ."! "!##"r"! .","m "+*! (er","!
me!."p"-"! +"m(""! ."p" .',"-*-"! per*("+"! *!*- re'')
%2&
Per*("+"! *!*- re'' e("#"'m"!" .'"*r .","m "" %1& .' "" .'"*-"!
-ep"." D'r-e". *!*- me!."p"-"! pere**"! ."! pe!e"p"!)
Pe)a)ka'a S'a4 Me(%s 5u)s%&al 0SM5 Pasal !: %1&
K" RSPAD G"o Soe(roo D'-e". me!#"!#-" ."! mem(er+e!'-"! S";
Me.' <*!#'o!", %SM<& "" "r"! Kom'e Me.'- e*"' -ee!*"! per"*r"! per*!."!# *!."!#"! "!# (er,"-* .' ('."!# -ee+""!)
%2&
K" RSPAD G"o Soe(roo D'-e". ."p" me!#"!#-" S*( Kom'e ""* P"!''"
"!# (er-"'"! .e!#"! -e#'""! pe,""!"! e-!' ."! !o! e-!' me.' "" "r"! Kom'e Me.'-)
Pe)el&m.&ka S'a4 Me(%s 5u)s%&al 0SM5 Pasal !; %1&
N"m" -e,ompo- Do-er ."! Do-er G'#' "!# (er+"- mem(er'-"! pe,""!"!
me.'- .' R*m"+ S"-' '!' ".","+ S"; Me.'- <*!#'o!", %SM<& RSPAD G"o Soe(roo D'-e".)
24
%2&
Pe!#e,ompo-"! "!##o" SM< (er.""r-"! ('."!# pe'",'"' me.'- "!# "."
.' RSPAD G"o Soe(roo D'-e".)
%3&
U!*- Ke,ompo- Do-er Um*m m"*- .","m SM< .o-er *m*m ."! *!*-
Ke,ompo- Do-er #'#' ."! .o-er #'#' pe'",' m"*- .","m SM< .o-er #'#')
%&
Peer" Pro#r"m Pe!.'.'-"! Do-er Spe'",' %PPDS& m"*- .","m SM< e*"'
.e!#"! pe'",'"' "!# e."!# .''-*')
%5&
N"m" "."+ pro;e'o!", me.' "!# -e"!##o""!!" (er"", ."r' -e*"9-e*"
S"; Me.' <*!#'o!", ."! ""* "!# me"-',' .''p,'! ',m* ere!* ".","+ Kom'e Me.'- RSPAD G"o Soe(roo D'-e".) Pasal #< T**"! ."! pe!#or#"!'"'"! S"; Me.' <*!#'o!", ".","+ "#"r "; me.' .' RSPAD G"o Soe(roo D'-e". ."p" ,e('+ me!"" .'r' ."! ;o-* er+"."p -e(**+"! p"'e! e+'!##" me!#+"',-"! pe,""!"! me.' "!# (er-*",'" ."! (er"!##*!# ""()
Pasal #1 %1&
Se"r" ".m'!'r"'"; Me.' <*!#'o!", (er"." .' (""+ P'mp'!"! RSPAD
G"o Soe(roo D'-e". !"m*! e"r" <*!#'o!", e("#"' pro;e' "!##o" S"; Me.' <*!#'o!", (er"!##*!# ""( -ep"." Kom'e Me.'- me,",*' -e*" SM<)
%2&
Pe!er'm""! eor"!# .o-er ""* .o-er pe'",' me!".' S"; Me.' <*!#'o!",
RSPAD G"o Soe(roo D'-e". .'.""r' -e*-"re,""! ."! +"r* meme!*+' per"r""! "!# .'e!*-"! o,e+ TNI AD ."! -ee!*"! per"*r"! per*!."!#"! "!# (er,"-* .' ('."!# -ee+""!)
%3&
Kee!*"! me!#e!"' "r" pe!er'm""! proe.*r pe!er'm""! ."! pe!#"*r"!
+"- ."! -e"'("! er" pe!#or#"!'"'"! S"; Me.' <*!#'o!", .'"*r e"r" ere!.'r' .","m "*r"! e!"!# MEDICAL STA BY LAWS RSPAD Ga'&' S&eb"&'& D%'kesa(+
Peu)asa S'a4 Me(%s
25
Pasal #! %1&
U!*- me**.-"! "" -e,o," -,'!' %clinical !oernance& .' RSPAD G"o
Soe(roo D'-e". em*" pe,""!"! me.' "!# .',"-*-"! o,e+ e'"p "; me.' .',"-*-"! "" pe!*#""! -,'!' ."r' K" RSPAD G"o Soe(roo D'-e".)
%2&
Pe!*#""! -,'!' e("#"'m"!" .'m"-*. p"." "" %1& (er*p" pem(er'"!
-ee!"!#"! -,'!' %clinical priile!e& o,e+ K" RSPAD G"o Soe(roo D'-e". me,",*' pe!er('"! *r" pe!*#""! -,'!' %clinical appoint#ent & -ep"." "; me.' "!# (er"!#-*"!)
%3&
S*r"
pe!*#""!
-,'!' %clinical appoint#ent & e("#"'m"!" .'m"-*. p"."
"" %2& .'er('-"! o,e+ K" RSPAD G"o Soe(roo D'-e". ee,"+ me!."p" re-ome!."' ."r' Kom'e Me.'-)
%&
D","m -e".""! ."r*r" K" RSPAD G"o Soe(roo D'-e". ."p" mem(er'-"!
*r" pe!*#""! -,'!' %clinical appoint#ent & "!p" re-ome!."' Kom'e Me.'-)
%5&
Re-ome!."' -om'e me.'- e("#"'m"!" .'m"-*. p"." "" %3& .'(er'-"!
ee,"+ .',"-*-"! -re.e!'",)
Pasal ## %1&
K" RSPAD G"o Soe(roo D'-e".
me!e"p-"! -r'er'" ."! "r"9"r"
pe!*#""! e'"p "; me.' *!*- *"* *#" ""* "(""! -,'!' ere!* ."! "-"! me!"mp"'-"! +", ere(* -ep"." e'"p e!"#" me.' "!# me!#+e!."-' pe!*#""! -,'!' .' r*m"+ "-')
%2&
Kr'er'" ."! "r"9"r" pe!*#""! e("#"'m"!" .'m"-*. .","m "" %1&
.'e"p-"! o,e+ K" RSPAD G"o Soe(roo D'-e". ee,"+ .'ep"-"' o,e+ Kom'e Me.'-)
%3&
Te!"#" me.' "!# e,"+ me!."p" pe!*#""! -,'!' .'r*m"+ "-' ."p"
(er"* e("#"' .o-er e"p ""* '."- e"p)
26
%&
4"!#-" "-* pe!*#""! e!"#" me.' %-ee!"!#"! -,'!'& ".","+ 2 %.*"&
"+*! -e*",' .'e"p-"! ,"'! o,e+ K" RSPAD G"o Soe(roo D'-e". .e!#"! memper+"'-"! -o!.'' .o-er ."! .o-er pe'",' "!# (er"!#-*"!) Pe!*#""! e!"#" me.' %-ee!"!#"! -,'!'& "-"! (er"-+'r e("#"' (er'-* "p"(',": ")
I'! pr"-e- "!# (er"!#-*"! *."+ '."- (er,"-* e*"' .e!#"!
per"*r"! per*!."!#9*!."!#"! "!# "." ""* ()
Ko!.'' ;''- ""* me!", e!"#" me.' "!# (er"!#-*"! '."-
m"mp* ,"#' me,"-*-"! me.' e"r" me!e"p ""* )
Te!"#" me.' e,"+ (er*'" 60 "+*! !"m*! "!# (er"!#-*"!
m"'+ ."p" p*," .'"!#-" e*"' .e!#"! per'm("!#"! P'mp'!"! RSPAD G"o Soe(roo D'-e". ""* .)
Te!"#" me.' '."- meme!*+' -ee!*"! ."! "r"9"r" "!#
.'e"p-"! .","m -o!r"- ""* e)
Te!"#" me.' .'e"p-"! e,"+ me,"-*-"! '!."-"! "!# '."-
pro;e'o!",
-e,"'!"!
""*
per',"-*
me!'mp"!#
,"'!!"
e("#"'m"!"
.'e"p-"! o,e+ Kom'e Me.' ""* ;)
Te!"#" me.' .'(er+e!'-"! o,e+ P'mp'!"! RSPAD G"o Soe(roo
D'-e". -"re!" "!# (er"!#-*"! me!#"-+'r' -o!r"- .e!#"! r*m"+ "-' ee,"+ me!#"*-"! permo+o!"! e(e,*m!")
Sya"a'-sya"a' Pembe"%a Ke3ea)a Kl%%s Pasal #* Pe!*#""! -,'!' .' r*m"+ "-' p"." eor"!# e!"#" me.' .'e"p-"! me,",*' r"p" -re.e!'", ."! "!# (er"!#-*"! meme!*+' er" me!e**' "r"9"r" "!# .'e!*-"! e("#"' (er'-* : ") Meme!*+' "r" e("#"' e!"#" me.' (er.""r-"! per"*r"! per*!."!#9 *!."!#"! -ee+""! "!# (er,"-* ."! -ee!*"! ,"'! e("#"'m"!" .'e"p-"! .","m (*-* pe.om"! '!') () Me!"!#"!'
p"'e!
.","m
(""9(""
e("#"'m"!"
.'e"p-"!
o,e+
P'mp'!"! RSPAD G"o Soe(roo D'-e". ee,"+ memper'm("!#-"! ."" .*-*!# ;"','" r*m"+ "-' ."! ('," .'per,*-"! e*"' re-ome!."' ."r' *(-om'e -re.e!'",)
27
) Me!"" e#"," '!."-"! "!# .'per,*-"! *!*- me!"m'! "#"r re-"m me.' '"p p"'e! "!# .'"!#"!'!" .' r*m"+ "-' erpe,'+"r" .e!#"! -*" ."! re-"m me.' .',e!#-"p' .","m "-* "!# ""r) .) Memper+"'-"! e#"," perm'!""! r*m"+ "-' "!# .'"!##"p ""r e+*(*!#"! .e!#"! '!."-"! .' r*m"+ "-' .e!#"! me!#"* p"." -ee!*"! pe,""!"! "!# (er,"-* .' r*m"+ "-') e) Mem"*+' e'-" -e.o-er"! "!# (er,"-* .' I!.o!e'" ("'- "!# (er-"'"! .e!#"! -e"'("! er+"."p m""r"-" p"'e! em"! e"" ."! .'r' e!.'r') ;)
Memper+"'-"! "r"9"r" *m*m pr"-e- -,'!' "!# (er,"-* .' r*m"+
"-') Peja)aa Mu'u Pelayaa Me(%s Pasal #/ U!*- pe!"#""! m** pe,""!"! me.' .' RSPAD G"o Soe(roo D'-e". .',"-*-"! *p""9*p"" .'"!"r"!" : ")
Pe!e"p"! Do-er Pe!"!##*!# 4""( Pe,""!"! %DP4P&)
()
Pem(e!*-"! T'm Kee,"m""! P"'e! % patient safety &)
Pasal #8 %1&
Do-er Pe!"!##*!# 4""( Pe,""!"! %DP4P& ".","+ eor"!# .o-er pe'",'
"!# (er"!##*!# ""( "" pe!#e,o,""! "*+"! me.' eor"!# p"'e!)
%2&
Kee!*"! me!#e!"' Do-er Pe!"!##*!# 4""( Pe,""!"! %DP4P& .' RSPAD
G"o Soe(roo D'-e". ".","+ e("#"' (er'-* : ")
DP4P U"m" *!*- p"'e! pr'(".' ""* "!# .'e(* .o-er pe'",'
".","+ .o-er "!# me!"!#"!' p"'e!) Ap"('," .'per,*-"! ",'+ "!##*!# ""( DP4P m"-" +"r* .',"-*-"! e"r" er*,' o,e+ p"r" p'+"-) ()
DP4P U"m" .'"(" o,e+ Koor.'!"or Pe,""!"! Me.' SM< *!' "!#
mer"" p"'e! per"m" -",' "p"('," er".' ",'+ "!##*!# ""( m"-" .',"-*-"! e"r" er*,' ."! ('," .'per,*-"! DP4P U"m" ."p" .'("!* o,e+ (e(er"p" DP4P "!# .'e!*-"! o,e+ Kep"," SM *!' "!# (er"!#-*"!) )
Te!"#" pe,"-"!" pe,""!"! me.' ("'- PPDS I PPDS II PPDGS I
PPDGS II m"*p*! peer" P3D "'( me!#'-*' -ee!*"! "!# .'#"r'-"! o,e+ Koor.'!"or Pe,""!"! Me.' SM< / U!')
28
.)
DP4P U"m" ."r' p"'e! "!# memer,*-"! per"""! (er"m" ".","+
.o-er -o!*,"! "+,' "!# per"m" -",' me!"!#"!' p"'e! ere(*) Ap"('," .'per,*-"! ",'+ "!##*!# ""( m"-" .',"-*-"! e"r" er*,' o,e+ p"r" p'+".e!#"! ;orm" "!# ".")
Pasal #9 %1&
T**"! pem(e!*-"! T'm Kee,"m""! P"'e! % patient safety & ".","+ : ")
Ter'p"!" (*."" -ee,"m""! p"'e! .' RSPAD G"o Soe(roo
D'-e".) ()
Me!'!#-"!" "-*!"(','" RSPAD G"o Soe(roo D'-e". er+"."p
p"'e! ."! m""r"-") )
Me!*r*!!" -e".'"! '."- .'+"r"p-"! .' RSPAD G"o Soe(roo D'-e".)
.)
Ter,"-"!"!" pro#r"m9pro#r"m pe!e#"+"! e+'!##" '."- er".'
pe!#*,"!#"! -e".'"! '."- .'+"r"p-"!)
%2&
T*#" T'm Kee,"m""! P"'e! RSPAD G"o Soe(roo D'-e". ".","+ e("#"' (er'-* : ")
Me!".' pe!##er"- .","m mem("!#*! (*."" -ee,"m""! p"'e!
r*m"+ "-') ()
Me!**! "#e!." pro#r"m -ee,"m""! p"'e! r*m"+ "-')
)
Mer*m*-"! -e('"-"! ."! proe.*r pro#r"m -ee,"m""! p"'e! r*m"+
"-') .)
Me,"-"!"-"! -oor.'!"' .e!#"! em*" *!' -er" .","m pe,"-"!""!
pro#r"m -ee,"m""! p"'e! r*m"+ "-') e)
Me!#-omp',"' ."! me!#"!",'' ."" '!'.e! -ee,"m""! p"'e! ."r'
e,*r*+ *!' -er") ;)
Me,"por-"! '!'.e! -ee,"m""! p"'e! -ep"." K" RSPAD G"o
Soe(roo D'-e". ."! -om'e -ee,"m""! p"'e! r*m"+ "-') #)
Mem(er'-"! re-ome!."' "" m"!"eme! r''-o -,'!' ."! !o! -,'!'
-ep"." K" RSPAD G"o Soe(roo D'-e". e("#"' ("+"! per'm("!#"!? +)
Me,"por-"! +"', -e#'""!!" -ep"." K" RSPAD G"o Soe(roo D'-e".
Ke3aj%ba Membua' Rekam Me(%k Pasal #:
29
%1&
Se'"p .o-er ."! .o-er #'#' .","m me!","!-"! pr"-'- -e.o-er"! .' RSPAD
G"o Soe(roo D'-e". "'( mem(*" re-"m me.'-) %2&
Re-"m me.'- e("#"'m"!" .'m"-*. .","m "" %1& +"r* e#er" .'(*" ."!
.',e!#-"p' ee,"+ p"'e! me!er'm" pe,""!"!) %3&
Pem(*""! re-"m me.'- e("#"'m"!" .'m"-*. .","m "" %2& .',"-"!"-"!
me,",*' pe!"""! ."! pe!.o-*me!"'"! +"', pemer'-""! pe!#o(""! '!."-"! ."! pe,""!"! ,"'! "!# e,"+ .'(er'-"! -ep"." p"'e!) %&
Se'"p pe!"""! -e .","m re-"m me.'- +"r* .'(*(*+' !"m" "-* ."!
"!." "!#"! .o-er .o-er #'#' ""* e!"#" -ee+""! ere!* "!# mem(er'-"! pe,""!"! -ee+""! e"r" ,"!#*!#) %5&
D","m +", er".' -e","+"! .","m me,"-*-"! pe!"""! p"." re-"m me.'-
."p" .',"-*-"! pem(e*,"!) %6& Pem(e*,"! e("#"'m"!" .'m"-*. .","m "" %5& +"!" ."p" .',"-*-"! .e!#"! "r" pe!ore"! "!p" me!#+',"!#-"! """! "!# .'(e*,-"! ."! .'(*(*+' p"r"; .o-er .o-er #'#' ""* e!"#" -ee+""! ere!* "!# (er"!#-*"!) %&
Do-er .o-er #'#' ."!/""* e!"#" -ee+""! ere!* (er"!##*!# ""( ""
"""! ."!/""* .o-*me! "!# .'(*" p"." re-"m me.'-)
Pasal #; %1&
Re-"m me.'- p"'e! r"" '!"p "'( .''mp"! e-*r"!#9-*r"!#!" *!*-
"!#-" "-* ,'m" %5& "+*! er+'*!# ."r' "!##", er"-+'r p"'e! (ero(" ""* .'p*,"!#-"!) %2&
See,"+ ("" "-* ,'m" %5& "+*! .',"mp"*' re-"m me.'- ."p" .'m*!"+-"!
-e*",' r'!#-""! p*,"!# ."! pere**"! '!."-"! me.'-) %3&
R'!#-""! p*,"!# ."! pere**"! '!."-"! me.'- e("#"'m"!" .'m"-*.
.","m "" %2& +"r* .''mp"! *!*- "!#-" "-* 10 %ep*,*+& "+*! er+'*!# ."r' "!##", .'(*"!" r'!#-""! ere(*) %&
Pe!'mp"!"! re-"m me.'- ."! r'!#-""! p*,"!# e("#"'m"!" .'m"-*. .","m
"" %1& ."! "" %3& .',"-*-"! o,e+ B"#m'!p"'e! ."!
30
%1&
I!;orm"' e!"!# '.e!'" .'"#!o' r'"" pe!"-' r'"" pemer'-""!
."! r'"" pe!#o(""! p"'e! +"r* .'"#" -er"+"'""!!" o,e+ .o-er .o-er #'#' e!"#" -ee+""! ere!* pe*#" pe!#e,o," ."! P'mp'!"! RSPAD G"o Soe(roo D'-e".) %2&
I!;orm"' e!"!# '.e!'" .'"#!o' r'"" pe!"-' r'"" pemer'-""!
."! r'"" pe!#o(""! p"'e! ."p" .'(*-" .","m +", : ") U!*- -epe!'!#"! -ee+""! p"'e! () Meme!*+' perm'!""! "p"r"*r pe!e#"pe!e#"-"! +*-*m "" per'!"+ pe!#".',"! ) Perm'!""! ."!/""* pere**"! p"'e! e!.'r' .) Perm'!""! '!'*'/,em("#" (er.""r-"!
+*-*m
.","m
-ee!*"!
r"!#-"
per*!."!#9
*!."!#"! e) U!*- -epe!'!#"! pe!e,''"! pe!.'.'-"! ."! "*.' me.' ep"!"!# '."- me!e(* '.e!'" p"'e!) %3&
Perm'!""! re-"m me.'- *!*- **"! e("#"'m"!" .'m"-*. .","m "" %2&
+"r* .',"-*-"! e"r" er*,' -ep"." P'mp'!"! RSPAD G"o Soe(roo D'-e".)
Pasal *1 %1&
Pe!e,""! e!"!# '' re-"m me.'- +"!" (o,e+ .',"-*-"! o,e+ .o-er ""*
.o-er #'#' "!# mer"" p"'e! .e!#"! ''! er*,' p"'e! ""* (er.""r-"! per"*r"! per*!."!#9*!."!#"!) %2&
P'mp'!"! RSPAD G"o Soe(roo D'-e". ."p" me!e,"-"! '' re-"m me.'-
e"r" er*,' ""* ,"!#*!# -ep"." pemo+o! "!p" ''! p"'e! (er.""r-"! per"*r"! per*!."!#9*!."!#"!) Ke"ahas%aa I4&"mas% Me(%s Pasal *! %1&
Se'"p .o-er ""* .o-er #'#' .","m me,"-"!"-"! pr"-'- -e.o-er"!
"'( me!'mp"! r"+"'" -e.o-er"!) %2&
R"+"'" -e.o-er"! ."p" .'(*-" +"!" *!*- -epe!'!#"! -ee+""!
p"'e! meme!*+' perm'!""! M"e,' H"-'m .","m per'."!#"! .' Pe!#".',"! .","m r"!#-" pe!e#"-"! +*-*m perm'!""! p"'e! e!.'r' ""* (er.""r-"! -ee!*"! per*!."!#9*!."!#"!)
31
Me)h&"ma'% Hak Pas%e Pasal *# %1&
Se'"p .o-er ""* .o-er #'#' ."! e!"#" -ee+""! ,"'!!" .","m mem(er'-"!
pe,""!"! -ee+""! "'( me!#+orm"' +"- p"'e!) %2&
H"- p"'e! .","m pe,""!"! -ee+""! e("#'m"!" .'m"-*. "" %1& ".","+
e("#"' (er'-* : ")
Me!."p" '!;orm"' e!"!# "" er'( R*m"+ "-'
()
Me!."p" '!;orm"' H"- ."! Ke"'("!)
)
Me!."p" ,""!"! "!# m"!*'"' "!p" .'-r'm'!"')
.)
Me!."p" ,""!"! (erm** e*"' "!."r)
e)
Me!."p" ,""!"! "!# e;e-'; ."! er+'!."r ."r' -er*#'"!)
;)
Me!#"*-"! pe!#".*"! "" pe,""!"!)
#)
Mem','+ .o-er ."! -e," e*"' -ee!*"! R*m"+ S"-')
+)
Mem'!" -o!*,"' e!"!# pe!"-'!")
')
Me!."p" pr'"' ."! -er"+"'""!)
)
Me!."p" '!;orm"' e!"!# -o!.''!" pe!"-')
-)
Mem(er'-"! pere**"! ""* me!o,"- '!."-"!)
,)
D'."mp'!#' -e,*"r#"!!" .","m -e".""! -r'')
m)
Me!","!-"! '("."+ e*"' "#"m")
!)
Mempero,e+ -e"m"!"! ."! -ee,"m""! .' R*m"+ S"-')
o)
Me!#"*-"! **, per("'-"! *!*- pe,""!"!)
p)
Me!o,"- ('m('!#"! ro+"!' "!# '."- e*"' "#"m")
F)
Me!##*#" ""* me!*!* R*m"+ S"-' ('," pe,""!"! '."- e*"'
"!."r r)
%3&
Me!#e,*+-"! pe,""!"! R*m"+ S"-' me,",*' me.'" e"-)
Ke"'("! p"'e! .","m pe,""!"! -ee+""! ".","+ e("#"' (er'-* : ") Me!""' e#"," per"*r"! ."! "" er'( "!# (er,"-* .' R*m"+ S"-'? () Mem"*+' e#"," '!r*-' .o-er ."! per"" .","m pe!#o(""!!"? ) Mem(er'-"! '!;orm"' .e!#"! **r ."! e,e!#-"p!" e!"!# pe!"-' "!# .'.er'" -ep"." .o-er "!# mer""? .) Me,*!"'/ mem(er'-"! 'm(","! "" "" pe,""!"! r*m"+ "-'/ .o-er? e) Meme!*+' +",9+", "!# e,"+ .'ep"-"'/ per"!'"! "!# e,"+ .'(*"!")
Pembe'uka Subk&m%'e (a Pa%'%a A!"#o$
32
Pasal ** (')
S*( Kom'e .'(e!*- o,e+ Ke*" Kom'e Me.'- *!*- me!"!#"!' ('."!# -+**
."! .'e"p-"! .e!#"! -ep**"! K" RSPAD G"o Soe(roo D'-e". "" **,"! Ke*" Kom'e Me.'-) ()
S*( Kom'e (er*#" mem("!* pe,"-"!""! *#" Kom'e Me.'-)
()
S*( Kom'e .'(e!*- e*"' .e!#"! -e(**+"! r*m"+ "-')
(*)
Kepe!#*r*"! S*( Kom'e .'e"p-"! .e!#"! S*r" Kep**"! K" RSPAD
G"o Soe(roo D'-e".) (+)
Ke"!##o""! S*( Kom'e er.'r' ."r' "; me.' e"p ."! e!"#" ,"'!
e"r" e" officio. (,)
(-)
S**!"! -epe!#*r*"! S*( Kom'e er.'r' ."r' : ")
Ke*" mer"!#-"p" "!##o"
()
Se-re"r' mer"!#-"p "!##o"
)
A!##o")
T"" -er" S*( Kom'e : ")
S*( Kom'e mem(*" -e('"-"! pro#r"m ."! proe.*r oper"'o!",)
()
S*( Kom'e mem(*" ,"por"! (er-"," ."! ,"por"! "+*!"! -ep"."
Ke*" Kom'e Me.'-) )
$"por"! "+*!"! (er'' e",*"' -e#'""! ."! re!"!" -e#'""!
(er'-*!") .)
B'"" oper"'o!", .'(e("!-"! p"." "!##"r"! RSPAD G"o Soe(roo
D'-e".)
()
S*( Kom'e "!# "." .' RSPAD G"o Soe(roo D'-e". ".","+ : ")
S*( Kom'e Kre.e!'",)
()
S*( Kom'e M** Pe,""!"! ."! M** Pro;e')
)
S*( Kom'e M** E'-" ."! D''p,'! Pro;e'
T%m A!"Ho$ Peel%'%a Du)aa Pela))a"a D%s%.l% Pasal */
33
%1&
K" RSPAD G"o Soe(roo D'-e". mem(e!*- T'm Ad%Hoc pe!e,''"! er+"."p
"."!" .*#""! pe,"!##"r"! .''p,'! "" re-ome!."' ."r' Ke*" Kom'e Me.'-) %2&
T"" "r" per'."!#"! T'm Ad%Hoc er+"."p 'm(*,!" .*#""! pe,"!##"r"!
.''p,'! ("#' e!"#" me.' .'"*r .","m S"!."r Proe.*r Oper"'o!", %SPO&)
BAB $ PENUTUP Ama(eme7Pe"ubaha Pasal *8 Per*("+"! er+"."p Per"*r"! I!er!", R*m"+ S"-' %Hospital By Laws& RSPAD G"o Soe(roo D'-e". ."p" .',"-*-"! e*"' .e!#"! -e(**+"!!")
Masa be"laku Pasal *9 Per"*r"! I!er!", R*m"+S"-' %Hospital By Laws& RSPAD G"o Soe(roo D'-e". '!' (er,"-* e"- "!##", .'e"p-"!
Ke'e'ua Pe"al%ha Pasal *: Sem*" per"*r"! r*m"+ "-' "!# .',"-"!"-"! e(e,*m (er,"-*!" Per"*r"! I!er!", R*m"+ S"-' %Hospital By Laws& RSPAD G"o Soe(roo D'-e". '!' .'!""-"! e"p (er,"-* ep"!"!# '."- (ere!"!#"! .e!#"! Per"*r"! I!er!", R*m"+ S"-' %Hospital By Laws& '!') D're-*r Kee+""! A!#-""! D"r"
.r) D"!'e, Te! Sp)S Br'#".'r 4e!.er", TNI
34
MARKAS BESAR ANGKATAN DARAT DIREKTORAT KESEHATAN
SURAT PERINTAH Nomor : Spr'! / 6 / IV / 2013
Per'm("!#"!
:
D""r
:
B"+" .","m r"!#-" pe!**!"! B*-* Pe.om"! Te!"!# Per"*r"! I!er!", R*m"+ S"-' %Hospital By Laws& RSPAD G"o Soe(roo D'-e". per,* .'-e,*"r-"! S*r" Per'!"+)
Kep**"! D'r-e". Nomor Kep/ 1 / I / 2013 "!##", 2 4"!*"r' 2013 e!"!# Pro#r"m Ker" ."! A!##"r"! D're-or" Kee+""! A!#-""! D"r" TA) 2013) DIPERINTAHKAN
Kep"."
:
N"m" P"!#-" / Go, Korp NRP/NIP ."! "(""! eper' er"!*m p"." ,"mp'r"! *r" per'!"+ '!')
U!*-
: 1) Seer'm"!" *r" per'!"+ '!' .' "mp'!# *#" ."! "!##*!# ""( "(""! e+"r'9+"r' .'*!*- e("#"' T'm Po-" pe!**!"! B*-* Pe.om"! e!"!# Per"*r"! I!er!", R*m"+ S"-' (Hospital By Laws) RSPAD G"o Soe(roo D'-e".) 2) Me,"por-"! pe,"-"!""! *#" '!' -ep"." D'r-e". *)p) K" RSPAD G"o Soe(roo D'-e".) 3)
Me,"-"!"-"! per'!"+ '!' .e!#"! r"" "!##*!# ""()
Se,e"') D'-e,*"r-"! .' 4"-"r" P"." "!##",
Apr',
2013
D're-*r Kee+""! A!#-""! D"r"
.r) D"!'e, Te! Sp) S Br'#".'r 4e!.er", TNI
35
Tem(*"! : 1) 2) 3) ) 5)
K" RSPAD G"o Soe(roo D'-e". Ir.' Se.'-e". K"*(.'('!"( D'-e". K"("#re!pro##"r Se.'-e". P"pe-" G"(p* NA)2)01)0
MARKAS BESAR ANGKATAN DARAT DIREKTORAT KESEHATAN
$"mp'r"! S*r" Per'!"+ D'r-e". Nomor : Spr'!/6 /IV / 2013 T"!##", : Apr', 2013
TIM KE$OMPOK KER4A PEN=USUNAN BUKU PEDOMAN TENTANG PERATURAN INTERNA$ RUMAH SAKIT %HOSPITAL BY LAWS& DI RSPAD GATOT SOEBROTO DITKESAD
NO 1 1) 2) 3) ) 5) 6)
)
@)
8) 10)
11) 12)
13)
NAMA PANGKAT KORPS / GO$ 2 .r) H"r*, $*;' H"m'. Sp)THT Br'#e! TNI .r) Po!o A#* Pr"oo Sp)B9KBD Ko,o!e, -m NRP 3306 .r) H"r."!o Sp)B Ko,o!e, -m NRP 3331 <"r'." H"r'om"ro!o S)K)M S)H M)H*m Ko,o!e, -m %K& NRP 31005 Do-o ",*o S)P. MAP $e-o, -m NRP 33100 $" O.e U.'! B"+"r*.'! SH MH)Ke $e-o, -m NRP 33566 I." "+*!' S)K)M $e-o, -m %K& NRP 3388 I)G)M R*.+'" S)I)P S)H $e-o, -m NRP 55335
<) D' B"*-' P S)So MARS $e-o, -m NRP 3368@ .r) Ir+"m!' Sp)B)BA $e-o, -m NRP 32501 Ro('!o! S're#"r S)H $e-o, -m NRP118001036120 =*!e-o S)E $e-o, -m NRP 182000806@ P*r"'!'!#'+ K"pe! -m %K& NRP 6263
4ABATAN STRUKTURA$ 3 Ke*" Kom'e Me.'- RSPAD G"o Soe(roo D'-e". "-" RSPAD G"o Soe(roo D'-e". D'r('!"!me. RSPAD G"o Soe(roo D'-e". P" A+,' K*me.o- RSPAD G"o Soe(roo D'-e". Se-re"r' RSPAD G"o Soe(roo D'-e". K"("#,'("!# C P*"-" S.'r('!("!# RSPAD G"o Soe(roo D'-e". K"("# Re!.", A." M";" S.'r('!"!#*m RSPAD G"o Soe(roo D'-e". S<) Per"" G'#' S*( I!", ","! < I!","' R"" 4","! RSPAD G"o Soe(roo D'-e". K" I!;o,"+" RSPAD G"o Soe(roo D'-e". K"("#.o- S.'r('!"!me. RSPAD G"o Soe(roo D'-e". K"("#p"m Se RSPAD G"o Soe(roo D'-e". K"("# Or'o." S.'r('!("!# RSPAD G"o Soe(roo D'-e". K"*r D'""+ B"# M'!pere RSPAD G"o Soe(roo D'-e".
POK4A N"r" S*m(er N"r" S*m(er N"r" S*m(er N"r" S*m(er Ke*" "-', Ke*"
Se-re"r'
A!##o"
A!##o" A!##o" A!##o" A!##o"
A!##o"
KET 5